Abstract：
OBJECTIVE: This study investigated the depot- and sex-specific associations of adiposity indicators with incident multimorbidity and comorbidity pairs.
METHODS: We selected 382 678 adults without multimorbidity (≥2 chronic diseases) at baseline from the UK Biobank. General obesity, abdominal obesity and body fat percentage indices were measured.
RESULTS: Cox proportional hazard regression analyses of general obesity indices revealed that for every one-unit increase in body mass index, the risk of incident multimorbidity increased by 5.2% (95% confidence interval 5.0%-5.4%). A dose-response relationship was observed between general obesity degrees and incident multimorbidity. The analysis of abdominal obesity indices showed that for every 0.1 increment in waist-to-height ratio and waist-to-hip ratio, the risk of incident multimorbidity increased by 42.0% (37.9%-46.2%) and 27.9% (25.7%-30.0%), respectively. Central obesity, as defined by waist circumference, contributed to a 23.2% increased risk of incident multimorbidity. Hip circumference and hip-to-height ratio had protective effects on multimorbidity onset. Consistent findings were observed for males and females. Body fat percentage elevated 3% (0.2%-5.9%) and 5.3% (1.1%-9.7%) risks of incident multimorbidity in all adults and females, respectively. Arm fat percentages elevated 5.3% (0.8%-9.9%) and 19.4% (11.0%-28.5%) risks of incident multimorbidity in all adults and males, respectively. The general obesity indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and central obesity increased the onset of comorbidity pairs, whereas hip circumference and hip-to-height ratio decreased the onset of comorbidity pairs. These adiposity indicators mainly affect diabetes mellitus-related comorbidity onset in males and hypertensive-related comorbidity onset in females.
CONCLUSIONS: Adiposity indicators are predictors of multimorbidity and comorbidity pairs and represent a promising approach for intervention.
METHODS: We selected 382 678 adults without multimorbidity (≥2 chronic diseases) at baseline from the UK Biobank. General obesity, abdominal obesity and body fat percentage indices were measured.
RESULTS: Cox proportional hazard regression analyses of general obesity indices revealed that for every one-unit increase in body mass index, the risk of incident multimorbidity increased by 5.2% (95% confidence interval 5.0%-5.4%). A dose-response relationship was observed between general obesity degrees and incident multimorbidity. The analysis of abdominal obesity indices showed that for every 0.1 increment in waist-to-height ratio and waist-to-hip ratio, the risk of incident multimorbidity increased by 42.0% (37.9%-46.2%) and 27.9% (25.7%-30.0%), respectively. Central obesity, as defined by waist circumference, contributed to a 23.2% increased risk of incident multimorbidity. Hip circumference and hip-to-height ratio had protective effects on multimorbidity onset. Consistent findings were observed for males and females. Body fat percentage elevated 3% (0.2%-5.9%) and 5.3% (1.1%-9.7%) risks of incident multimorbidity in all adults and females, respectively. Arm fat percentages elevated 5.3% (0.8%-9.9%) and 19.4% (11.0%-28.5%) risks of incident multimorbidity in all adults and males, respectively. The general obesity indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and central obesity increased the onset of comorbidity pairs, whereas hip circumference and hip-to-height ratio decreased the onset of comorbidity pairs. These adiposity indicators mainly affect diabetes mellitus-related comorbidity onset in males and hypertensive-related comorbidity onset in females.
CONCLUSIONS: Adiposity indicators are predictors of multimorbidity and comorbidity pairs and represent a promising approach for intervention.
摘要：
目的：本研究调查了肥胖指标与多发病和合并症对的特异性和性别相关性。
方法：我们从英国生物库选择了382678名基线无多重性（≥2种慢性疾病）的成年人。一般肥胖，测量腹部肥胖和体脂百分比指数。
结果：一般肥胖指数的Cox比例风险回归分析显示，体重指数每增加一个单位，多发病风险增加5.2%(95%置信区间5.0%-5.4%).在一般肥胖程度和多发病之间观察到剂量反应关系。腹型肥胖指标分析显示,腰围身高比和腰臀比每增加0.1,多发病风险分别增加42.0%(37.9%-46.2%)和27.9%(25.7%-30.0%),分别。中心性肥胖,由腰围定义，导致多发病风险增加23.2%.臀围和臀高比对多发病有保护作用。在男性和女性中观察到一致的发现。所有成年人和女性的体脂百分比增加了3%(0.2%-5.9%)和5.3%(1.1%-9.7%)的多发病风险，分别。在所有成年人和男性中，手臂脂肪百分比增加了5.3％（0.8％-9.9％）和19.4％（11.0％-28.5％）的多发病风险，分别。一般肥胖指数，腰围,腰围与身高比,腰臀比和中心性肥胖增加了合并症对的发作，而臀围和臀高比减少了合并症对的发生。这些肥胖指标主要影响男性的糖尿病相关合并症发作和女性的高血压相关合并症发作。
结论：肥胖指标是多发病率和合并症对的预测因子，代表了一种有希望的干预方法。
方法：我们从英国生物库选择了382678名基线无多重性（≥2种慢性疾病）的成年人。一般肥胖，测量腹部肥胖和体脂百分比指数。
结果：一般肥胖指数的Cox比例风险回归分析显示，体重指数每增加一个单位，多发病风险增加5.2%(95%置信区间5.0%-5.4%).在一般肥胖程度和多发病之间观察到剂量反应关系。腹型肥胖指标分析显示,腰围身高比和腰臀比每增加0.1,多发病风险分别增加42.0%(37.9%-46.2%)和27.9%(25.7%-30.0%),分别。中心性肥胖,由腰围定义，导致多发病风险增加23.2%.臀围和臀高比对多发病有保护作用。在男性和女性中观察到一致的发现。所有成年人和女性的体脂百分比增加了3%(0.2%-5.9%)和5.3%(1.1%-9.7%)的多发病风险，分别。在所有成年人和男性中，手臂脂肪百分比增加了5.3％（0.8％-9.9％）和19.4％（11.0％-28.5％）的多发病风险，分别。一般肥胖指数，腰围,腰围与身高比,腰臀比和中心性肥胖增加了合并症对的发作，而臀围和臀高比减少了合并症对的发生。这些肥胖指标主要影响男性的糖尿病相关合并症发作和女性的高血压相关合并症发作。
结论：肥胖指标是多发病率和合并症对的预测因子，代表了一种有希望的干预方法。
